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NPI Code Detail

MEDICARE: LAURA C JOHNSON PT, DPT

MEDICARE: LAURA C JOHNSON PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251P0200XPediatric Physical Therapist36792

General Provider Information

NPI Number : 1295320224
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA C JOHNSON PT, DPT
Provider Business Mailing Address
First Line : 316 ARCHIBALD DR
Second Line :
City : GOOSE CREEK
State : SC
Zip : 29445-8211
Country : US
Telephone Number : 843-330-1660
Fax Number :
Provider Business Practice Location Address
First Line : 2387 LANTERN ST
Second Line :
City : CHARLESTON
State : SC
Zip : 29414-4850
Country : US
Telephone Number : 317-750-9879
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2021
Last Update Date : 03/02/2021

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Directions to “ LAURA C JOHNSON PT, DPT” Practice Location

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